TRAINEE doctors working in some of Northern Ireland's biggest hospitals have revealed their concerns about carrying out emergency care without proper supervision, a review has discovered.
Complaints about "unprofessional behaviour" among a small number of consultants and "potential gender discrimination" against female trainees at Antrim Area hospital were also unearthed by the doctors' regulator, the General Medical Council (GMC).
Inspectors visited all five health trusts earlier and Queen's University earlier this year to get first-hand accounts of the experiences of doctors in training and medical students.
Junior medics based at the South West Acute hospital (SWAH) in Enniskillen said they had been left in situations" outside of their competence" during out-of-hours work due to a lack of senior doctors being on the ground.
Staff shortages and rota gaps also led to junior trainees at Craigavon Area hospital being responsible for the "emergency pager" for certain cases "when more senior trainees weren't available".
The Southern trust, which is responsible for Craigavon, described the problem as a "one-off" but said they will continue to monitor staffing. The Western trust said they had employed more locums to cover out-of-hours work at SWAH but were looking at a more "sustainable option".
While the GMC team commended the training given in trauma and orthopaedics at the Belfast health trust, they warned of problems in junior A&E doctors getting adequate supervision at Antrim Area hospital.
"They told us they can't always contact consultants on the ward and there have been times when they've had to find another consultant on a different ward. Some clinical supervisors in emergency medicine agreed that supervision is variable - they told us that while they may not always be available on the wards, they are accessible and can be contacted," the report states.
There are currently more than 1,800 trainee doctors in the north and the GMC team found their overall support and education was positive.
They noted that trusts were trying to rectify the concerns raised during the inspections between February and April.
Dr Colin Melville, the GMC's director of Education and Standards, said: "We recognise the pressure frontline care is under, and that it can have a damaging impact on medical education. Northern Ireland is no different to anywhere else in the UK in that respect, and it is vitally important that patient safety is protected by ensuring training continues to be delivered to the highest standard.
"So although we identified a small number of concerns, overall we were pleased at the high standards and commitment across the country."
